因子分析法在评价结核病患者生存质量量表中的应用

目的以自制的结核病患者生存质量测定量表为依据，探讨因子分析法在研制生存质量量表中的应用。方法在已确诊为结核病的门诊病人及住院病人中随机抽取253例研究对象，用自制结核病人生存质量量表（QLI-TBV1．0）进行测评，利用因子分析方法及相关性分析法对调查结果进行分析。结果通过对结核病人生存质量测定量表的47个条目进行主成份因子分析，按特征根大于1并经方差最大旋转后提取12个主成份。累计贡献率达76．0％。其中，共性模块提取出8个主成份，累计贡献率达72．19％；特异性模块提取出4个主成份，累计贡献率达68．33％；各维度的条目与本维度的相关系数较大，而与其他维度的相关系数较小。结论用因子分析法结合维度相关性分析显示此量表的效度较好，因子分析是生存质量测定量表研制过程中一种行之有效的统计分析方法。     

慢性病老年患者的生活质量及相关因素

目的：探讨不同人口学特征和老年慢性病患者的生活质量。方法：对150例年龄≥60岁的慢性病患者进行人口社会学调查，并采用症状自评量表(SCL—90)、社会功能缺陷筛选量表(SDSS)、日常生活能力量表(ADL)、生活质量量表(QOL)对其生活质量状况进行评定。结果：男性社会功能明显低于女性，但生活质量无明显差别。不同年龄、受教育程度、家庭状况、职业、经济收入的人群之间生活质量存在差异。结论：老年慢性病患者的生活质量与人口社会学特征有关。     

儿童生存质量测定量表PedsQL3.0心脏病模块中文版的信度和效度分析

背景:心脏病患儿的生存质量受到越来越多的关注,但是国内缺少相关的研究报道。缺乏适合的量表是主要原因之一。目的:考察儿童生存质量量表PedsQL3.0心脏病模块中文版的信度和效度。方法:采用国际通用的量表翻译改造程序,将英文版的儿童生存质量测定量表PedsQL3.0心脏病模块翻译改造成中文。并将中文版量表运用于广州市3家三级甲等医院的310例门诊部或住院部的心脏病患儿及其家长。分析量表的可行性、内部一致性、内容效度、结构效度等。结果与结论:父母和患儿共发放480份问卷,回收462分,答卷的条目缺失率低于1%;除5~7岁患儿自评问卷的感知身体外貌维度的Cronbach′sα系数为0.35外,其他量表各个方面的Cronbach′sα系数为0.66~0.94;量表的各条目与其所属方面和领域之间相关较强,而与其他方面和领域相关较弱;证实性因子分析结果表明因子结构与量表的理论结构一致。结果提示PedsQL3.0心脏病模块中文版的信度和效度良好,可以应用于中国心脏病儿童生存质量的研究。     

胆石症手术患者生活质量量表的编制策略及条目筛选

目的：编制评价胆石症手术患者生活质量的多维测评量表。方法：采用初始量表对200例将实施胆石症手术的患者进行生活质量的实测后，采用t检验法．相关分析法．因子分析法等5种方法联合进行条目筛选，由保留条目组建量表测试版。结果：①胆石症手术患者生活质量量表（Quality of Life Scale of operating on cholelithiasis，QLSOC）测试版量表由23个条目组成4个维度，其中疾病维度ll条目，生理维度4条目，社会维度5条目，心理维度3条目；②条目分析显示测试版量表条目与各维度．总分问的相关分别为0．297～0．868、0．389～0．747；③探索性因素分析抽取6个共因子．累积解释变异量为69．446％，可分属四个维度；④总量表和各维度的Cronbach’sα系数为0．774～0．907。结论：胆石症手术患者生活质量量表的建构基本符合理论构想，达到了编制的要求。     

老年人生存质量量表条目的初步筛选

目的:对世界卫生组织生存质量测定量表老年人模块条目池中的条目用6种方法进行筛选,考察克朗巴赫系数法和重测系数法的功能.方法:利用多阶段抽样的方法收集资料,除离散程度法、相关系数法等常用方法外新增克朗巴赫系数法和重测系数法从内部一致性和稳定性角度筛选条目.结果:将多种方法选中的条目保留下来形成世界卫生组织生存质量测定量表的老年人模块,克朗巴赫系数法和重测系数法能使内部一致性和稳定性较好的条目入选.结论:以往常用的4种方法有助于选择代表性、独立性和区分性较好的条目,克朗巴赫系数法和重测系数法则从内部一致性和稳定性角度选择较好的条目,建议与前4种方法结合起来运用于条目筛选.     

保髋治疗股骨头坏死的特异性量表

背景：目前评价保髋治疗的疗效标准较多,没有统一标准,因此保髋治疗的疗效缺乏一定的可比性。 目的：参考WHO生存质量量表发展模式及医药领域量表研制与应用指南,试图研制一款特异性的用于评价保髋治疗疗效的生存质量量表。 方法：通过复习文献和小组讨论,在相关理论指导下,参照一般量表制定的程序化方式,制定理论模型,通过患者访谈形成条目池,优化条目并初步筛选后形成预调查表。用预调查表进行现场调查,借助专家重要性评分、因子分析、离散趋势法、逐步回归、判别分析和Cronbach’s α系数等统计学方法筛选条目,形成终选量表。 结果与结论：终量表包括生理、心理、社会及健康意识4个领域,分疼痛、跛行、关节功能、积极因素、消极因素、社会角色、社会关系、健康的自我评价、对疾病的了解9个方面,外加一条独立条目,共32个条目。终选量表一旦完成其科学性考核,将是一款适用于股骨头坏死保髋治疗疗效评价的特异性量表,将对接受保髋治疗的患者提供一个更为全面的疗效评价。     

中学生网络成瘾诊断量表的初步编制

目的：根据项目反应理论（IRT）编制中学生网络成瘾诊断量表（IADDS），并对其进行信效度检验。方法：根据网络成瘾的理论模型初步编制29个条目，二值评分。施测样本为1400名初、高中生网络使用者。结果：①在测量误差0．1952水平，选取13个条目组成量表。②条目区分度1．2928—2．2859。③条目程度0．5907-1．0035。④因素分析抽取3个因子，解释53．674％的总方差。⑤IADDS与效标显著相关（K=0．857）。最佳划界值5，敏感度91．5％，假阳性率5．7％。结论：该量表条目质量及信效度符合IRT与心理测量学要求，可用于中学生网络成瘾的诊断。     

WHOQOL-BREF在广泛性焦虑症患者中应用的信度及效度研究

目的：评估世界卫生组织生命质量测定量表简表在广泛性焦虑症病人中的信度和效度。方法：由专业医生对42例符合CCMD-3广泛性焦虑症诊断标准的门诊初诊患者评定世界卫生组织生命质量测定量表简表、健康状况调查问卷、汉密顿焦虑量表和大体评定量表，在治疗第四周予以重测。对量表的内部一致性信度、重测信度、平行效度及经验效度等指标进行分析。结果：WHOQOI-BREF的Guttman分半信度为0．767，Cronbach’s α系数为0．827，各维度的Cronbach's α系数较好，重测后各项目的相关系数均在0.348～0．646之间；WHOQOL-BREF的生理、心理、社会关系和环境分量表与SF-36多数分量表呈显著相关，WHOQOL-BREF的生理、心理、社会关系和环境分量表与GAS评分呈显著正相关；广泛性焦虑症患者的焦虑症状评分与WHOQOL-BREF的多个分量表分呈显著性负相关，经治后广泛性焦虑症患者生命质量及焦虑症状均有显著性的改善，具有统计学意义。结论：WHOQOL-BREF具有较好的信度和效度，能较全面地评价广泛性焦虑症患者生命质量。     

乳腺癌患者生命质量测定量表(FACT-B)中文版的修订

目的：修订乳腺癌生命质量测定量表FACT-B的中文版，并对其进行考评。方法：通过量表的释译、回译及文化调适，制定中国版的FACT-B，并通过165例乳腺癌患者进行的测定对量表进行考评。结果：躯体状况、社会／家庭、情感状况、功能状况、附加的关注5个领域以及总量表的重测信度分别为0．82、0．85、0.85、0．85、0．86、0．89；5个领域内部一致性信度的。值分别为0．84、0．84、0．79、0.83、0．61;该量表在人院治疗2-4周后能够反映出生命质量的变化。结论：FACT-B中文版具有较好的信度、效度及反应度，可用于中国乳腺癌患者的生命质量测定。     

直肠癌造口患者的心理控制源、生命质量和应对方式

目的:探讨直肠癌造口患者心理控制源、生命质量和应对方式的关系,为直肠癌造口患者的健康干预提供依据.方法:本研究为横断面调查.选取直肠癌造口术后患者135例,用多维度健康状况心理控制源量表(MHLC)、癌症患者生命质量测定量表体系之大肠癌量表(QLICP-CR)和癌症应对方式问卷(CCMQ),分别测评患者的健康心理控制源、生命质量状况和应对方式.结果:回收有效问卷131份.直肠癌造口患者的MHLC的健康内部控制分量表得分为(20.5±5.3)、健康权威人士控制分量表得分(23.1±-4.4)、健康机遇控制分量表得分(19.0±4.3);QLICP-CR总分标准分为(57.0±19.7),其中,共性症状和副作用维度标准分最高(61.9±24.1),躯体功能维度标准分最低(50.4±22.0);CCMQ的面对维度得分最高(2.8±0.4),发泄维度得分最低(2.0±0.6).直肠癌造口患者MHLC的健康权威人士控制分量表得分与QLICP-CR总分及躯体功能、大肠癌特异模块维度得分呈正相关(r=0.19、0.27、0.20,均P ＜0.05);健康内部控制分量表得分与QLICP-CR心理功能维度得分、CCMQ面对维度得分呈正相关(r=0.18、0.21,均P＜0.05).CCMQ面对维度在健康内部控制和患者心理功能之间的中介效应不显著.结论:本研究提示,健康权威人士控制倾向明显的患者总体生命质量较高.     

Prevention of recurrent depressive episodes with milnacipran: consequences on quality of life

BACKGROUND: Depression is now seen as a chronic disabling condition that spans the patient's lifetime and creates significant medical, economic and quality of life consequences. METHODS: 500 depressed patients were treated with milnacipran for 6 months. A total of 214 recovered patients were randomised to receive either milnacipran (50 mg bid) or a matching placebo for a 1-year recurrence prevention phase. Recurrence rate was the primary criteria; quality of life (QoL) consequences were evaluated through a shortened version of the French Sickness Impact Profile (SIP), the Depression Impact Profile (DIP). RESULTS: Milnacipran demonstrated its ability to reduce recurrences (Odds-Ratio=1.5; P<0.05), with a more marked effect in recovered patients with few residual symptoms (Odds-Ratio=3.0). Responders who continued treatment with milnacipran had a dramatic improvement in their quality of life, although patients with residual symptoms still experienced some deterioration in their QoL (recreation, emotional, social, alertness and home assistance scores). Even recovered patients having zero scores on the Hamilton Depression Rating Scale-21 items (HDRS) had some QoL deterioration. The DIP emotional score was found to be more predictive of recurrence than the HDRS. Overall, the QoL was improved for those in the milnacipran group in comparison to placebo on the mobility, communication, psycho-social and total scores. LIMITATIONS: The QoL evaluation was a secondary criteria; no a priori sample size estimate was performed. The choice of a generic QoL instrument might have reduced the sensitivity to clinical changes in depression. CONCLUSIONS: Prevention of recurrence in MDD with milnacipran contributes to an improvement in the QoL.     

A psychological support concept and quality of life research in a liver transplantation program: an interdisciplinary multicenter study

Considering the increasing number of liver transplantations with longer periods of transplant function, there is a growing need for quality of life research in the field. In addition to lethality, mortality and rehabilitation, parameters of 'quality of life' are to be evaluated: the patient's rating of his subjective physical symptoms, psychological condition (anxiety, depression and mental adjustment), social reintegration and life satisfaction. This paper describes our psychological support program that has been established at the Hamburg LTX center as well as the first results of the ongoing QoL research study. Using the methods developed by the Hamburg Study group on 'quality of life in surgery', 38 liver transplantation patients of the University of Chicago (cross-sectional study with control groups of patients with chronic liver disease as well as healthy individuals) and 29 patients of the University Clinic of Hamburg (longitudinal study with points of evaluation before and 2, 6, 12, 24 and 36 months after transplantation) have been evaluated. First results: (1) All successfully transplanted patients show a significant postoperative increase of their overall quality of life. (2) The psychological parameters of quality of life are only partly correlated with physical symptoms. (3) There is a high correlation between rejection crisis periods and the decrease of all quality of life parameters. (4) In both samples men have a lower quality of life than women, (5) Preoperative depression and lack of social support might be considered as being possible risk factors for long-term survival. (6) Long-term survivors rate their quality of life significantly higher than patients with chronic liver disease and--despite some persisting somatic restrictions--as high as healthy controls. (7) A psychotherapeutic support program increases the patient's compliance resulting a better adaption to the transplant procedure including rehabilitation.     

Evaluation and impact of chronic cough: comparison of specific vs generic quality-of-life questionnaires.

BACKGROUND: Chronic cough is a common condition that has a significant impact on health-related quality of life (HRQoL). OBJECTIVE: To investigate whether chronic cough is associated with adverse psychological and physical effects on quality of life (QoL) using different HRQoL questionnaires. METHODS: Forty patients were recruited for the study. The diagnostic workup was mainly based on the pathogenic triad in chronic cough: postnasal drip syndrome, asthma, and gastroesophageal reflux disease. The HRQoL was evaluated with the cough-specific quality-of-life questionnaire (CQLQ), Leicester Cough Questionnaire (LCQ), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale. RESULTS: Symptom scores were significantly correlated with the CQLQ and LCQ (beta = .415 and beta = -.272, respectively) but not with the SF-36. A statistically significant difference was found in all questionnaires, except the physical component summary domain of the SF-36, after specific therapy. Correlation between the 2 specific HRQoL questionnaires was moderate to high when pretreatment and posttreatment scores were compared (r = -0.42 and r = -0.60). Concurrent validity of the LCQ was higher than the CQLQ when compared with the SF-36 domains. The effect size of each specific QoL questionnaire was 1 or higher after treatment, whereas it was much less in the SF-36. There was no change in depression with treatment despite anxiety. Posttreatment symptom scores were related with anxiety (r > 0.40) CONCLUSIONS: Because HRQoL is important to patients, a cough-specific HRQoL instrument, either the CQLQ or LCQ, should be routinely used to optimally evaluate the impact of cough on patients and to evaluate the efficacy of cough-modifying agents.     

Manual lymphatic drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial

Introduction

Manual lymphatic drainage (MLD) is an adjunctive method of chronic venous disease (CVD) therapy. Evaluation of the change at the clinical stage, hemodynamic parameters and quality of life (QoL) following venous system surgery in CVD patients undergoing MLD preoperatively are the most interesting aspects of the study.

Material and methods

The CVD patients qualified for elective surgery of the venous system were randomly divided into 2 groups: the MLD group (n = 38) and the control group (n = 32). In the preoperative period, the MLD group underwent a series of MLD through a period of 2 weeks. The control group did not undergo MLD preoperatively. Both groups were evaluated for CVD staging on the day of qualification for surgery and between 25 and 30 days post-operatively. Additionally, the MLD group was evaluated after the series of MLD. The CVD staging was evaluated in both groups with a QoL questionnaire (CIVIQ), CEAP classification, foot volumetry (FV) and venous refilling time (VRT).

Results

Parameter values obtained in the MLD group (before treatment/after MLD/after surgery): CEAP 2.23/2.15/2.10, VRT 15/13/15.6, FV 3625/3472/3418, CIVIQ-complaints: 54.4/43.8/38.2 and CIVIQ-meaning: 57.3/49.3/43.1. Parameter values obtained in control group (before surgery/after surgery): CEAP 2.4/2.12, VRT 13/14.9, FV 3581/3559, CIVIQ-complaints: 51.9/38.7 and CIVIQ-meaning: 53.7/40.6. The CVD patients statistically improved in CEAP staging, FV and QoL in both groups (p < 0.05).

Conclusions

The MLD alone significantly reduced FV in patients with CVD, also improving their QoL. The MLD applied in CVD patients at the preoperative stage results in better surgical outcome, which is demonstrated by reduced disease progression, FV reduction and improvement in the QoL.     

Levocetirizine in persistent allergic rhinitis and asthma: effects on symptoms, quality of life and inflammatory parameters

Background Levocetirizine (LCZ) has been shown to be effective in allergic rhinitis. We evaluated its clinical efficacy, antinflammatory actions and its effects on quality of life (QoL) with a specific instrument in the asthma-rhinitis comorbidity. Methods Fifty adult patients with persistent rhinitis with/without asthma were enrolled. After a 1-week run-in for baseline evaluation, they were randomized to LCZ or placebo for 8 weeks. Cromolyn and salbutamol were permitted on demand. Rhinoconjunctivitis and asthma symptoms were evaluated by diary cards. QoL was assessed by the specific Rhinasthma questionnaire and the generic SF-36 at different time-points. Nasal scrapings and lavages were also performed for inflammatory cell count and mediator assessment. Results Ten patients dropped out for unrelated reasons and the remaining completed the study with no side-effect. Symptoms began to decrease in the active group at the second week of treatment when the difference with the placebo group became significant (0.05) and so remained until the end of the trial. Starting from 2 weeks of therapy, there was a significant decrease vs. baseline in all the four components of the Rhinasthma questionnaire only in the active group. The intergroup comparison became significant (P<0.05) at 4 weeks. The SF-36 detected only sporadic differences between groups. Eosinophils and neutrophils in nasal scraping were significantly decreased in the LCZ group vs. baseline at all times. Nasal mediators were under the detection limits and no analysis could be performed. In the active group, only two patients used rescue medications compared with 13 patients in the placebo group. Conclusions LCZ is clinically effective and capable of improving the rhinitis-asthma-related QoL.     

Sexual dysfunction in patients with allergic rhinoconjunctivitis.

BACKGROUND: Sexual dysfunction in chronic diseases has recently attracted attention owing to its impact on quality of life (QoL). Allergic rhinoconjunctivitis (ARC) affects QoL, causing limitations in many areas. However, there has not been research on changes in sexual function in patients with ARC. OBJECTIVE: To report the effect of ARC and its treatment on sexual function in men and women. METHODS: Forty-three sexually active patients with seasonal ARC aged 22 to 49 years were included in the study. The control group was composed of 40 healthy individuals aged 22 to 46 years. Conjunctival symptom scores (CSSs) and nasal symptom scores (NSSs) of patients with symptomatic ARC were determined, as were sexual function scores (SFSs) using the Female Sexual Function Index and the International Index of Erectile Function during allergen exposure in the pollination period and after treatment with oral desloratadine, 5 mg/d, for 30 days. The SFSs were evaluated in the control group. RESULTS: The CSSs and NSSs significantly improved in treated ARC (P < .001). In women, Female Sexual Function Index results in symptomatic ARC were significantly lower than in treated ARC and controls (P = .003). In men, International Index of Erectile Function results in treated ARC (P = .001) and controls (P < .001) were significantly higher than in symptomatic ARC. Furthermore, correlation between improvement in CSSs and NSSs and that of SFSs was determined (P = .007 for women; P = .001 for men). CONCLUSION: Improvement in sexual function as a variable of QoL may accompany the treatment of symptoms in patients with ARC.     

Evaluation of asthma knowledge and quality of life in Hungarian asthmatics

BACKGROUND: The objective was to develop an educational instrument, to assess its impact as an intervention instrument and to examine quality of life (QoL). METHODS: 119 asthmatics were randomized (64 in the intervention and 55 in the reference group). The education instrument was developed based on the EuroPharm-Forum Guidelines and its impact assessed by a self-developed questionnaire. Patients' QoL, asthma knowledge was assessed twice, once before and after the education seminar, education was only provided for the intervention group. QoL was measured with the St George's Respiratory Questionnaire (SGRQ) and a visual analogue scale (VAS). RESULTS: We found significant differences in answers to the asthma questions, by 40% improvement, but no changes in the control group. In inhaler-use technique, we could not find significant changes neither in the intervention nor in the control group. There were no significant differences between the results of the two visits neither with the VAS nor with the SGRQ on the QoL data. CONCLUSION: The results indicate that asthmatics experience lower QoL. As the subjects were regularly controlled asthmatics they had better general knowledge and inhaler-use technique was expected. The results suggest that it is necessary to regularly refresh asthma knowledge, to assess patients' self-management plans to achieve long-term effectiveness of asthma management.     

Sublingual allergen immunotherapy in HIV‐positive patients

HIV infection is a relative contraindication for allergic immunotherapy (AIT). In the last decade, highly active antiretroviral therapy (HAART) has improved the immune function and life expectancy in HIV‐infected patients whose respiratory allergic incidence is similar to the general population. We evaluated the safety and clinical effectiveness of sublingual immunotherapy in a group of grass pollen‐allergic HAART‐treated HIV‐positive patients. Thirteen patients received sublingual immunotherapy (SLIT) tablet (Oralair, Stallergenes©) and symptomatic therapy and were compared with nine patients receiving symptomatic therapy alone. Clinical benefits were evaluated by the analysis of total combined score (TCS), sum of symptom–medication score, and a quality of life (QoL) questionnaire. HIV viral load and peripheral TCD4 lymphocytes were analyzed at the beginning and at the end of the study. Clinical efficacy data showed a significant improvement in SLIT‐treated patients compared to controls (TCS: P = 0.0001; QoL: P = 0.03). We did not observe any significant alteration of TCD4 cell counts and viral load (VL) in both groups. Our preliminary data showed that SLIT therapy in viro‐immunological controlled HAART treated HIV positive patients was efficacious, safe and well tolerated.     

Changes in personal control as a predictor of quality of life after pulmonary rehabilitation

OBJECTIVE: Perceptions of mastery and self-efficacy may be related to better outcomes in pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). This study examined (1) whether patients with COPD improved during a rehabilitation programme with respect to quality of life (QoL) and perceptions of self-efficacy and mastery, and (2) whether increased perceptions of mastery and self-efficacy contributed to a higher QoL after rehabilitation. METHODS: Thirty-nine consecutive COPD patients (aged 60.5 +/- 9.0) were included from a rehabilitation centre and completed self-report questionnaires assessing symptoms, QoL, and perceptions of personal control. RESULTS: COPD patients improved during rehabilitation in overall QoL and self-efficacy, although no significant changes were found in QoL domains and mastery. Changes in self-efficacy during rehabilitation contributed to the explanation of the social and psychological functioning QoL domains. CONCLUSION: Even in seriously impaired COPD patients in advanced stages of illness, positive changes in self-efficacy and overall well-being can be established during rehabilitation. Changes in self-efficacy were related to a better QoL, suggesting the importance of personal control in the adjustment to COPD. PRACTICE IMPLICATIONS: Focussing more explicitly on the enhancement of perceptions of personal control in COPD patients may be an important aim of pulmonary rehabilitation.